How is patient safety understood by healthcare professionals? The case of Bhutan

Objective:
The aim of the study was to explore how the term patient safety is understood by healthcare professionals (nurses, educators, doctors, ward managers, senior managers, and health assistants), all of whom are responsible for promoting the patient safety agenda in the Bhutanese healthcare system.

Methods:
The study was conducted as a naturalistic inquiry using qualitative exploratory descriptive inquiry. A purposeful sample of 94 healthcare professionals and managers was recruited from three different hospitals, a training institute, and the Ministry of Health. Data were collected via in-depth individual interviews. All data were subsequently analyzed using thematic analysis strategies.

Results:
Data analysis revealed variation in the understanding of patient safety among healthcare professionals. Although most participants understood patient safety as fundamentally concerning “doing no harm” or “reducing the risk of harm or injuries” to patients, some understood patient safety as simply having sturdy infrastructure/buildings with sufficient space to manage public health emergencies such as earthquakes, floods, and epidemics. Some confused patient safety with quality of care and patient rights.

Conclusions:
Inadequate understanding of the term patient safety has potential to hinder improvement of patient safety processes and practices in the Bhutanese healthcare system. To improve patient safety in Bhutan’s healthcare system, patient safety training and education need to be provided to all categories of healthcare professionals.